Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $205.92 / $205.92 / $4,000.00	Facility		$205.92	$205.92	$4,000.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.85 / $37.85 / $37.85	Facility	26	$37.85	$37.85	$37.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.82 / $128.59 / $214.70	Professional		$113.82	$128.59	$214.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $22.21 / $32.56	Professional	26	$11.78	$22.21	$32.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.68 / $111.87 / $189.29	Professional	TC	$99.68	$111.87	$189.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.58 / $223.75 / $283.70	Professional		$148.58	$223.75	$283.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.51 / $34.72 / $44.24	Professional	26	$16.51	$34.72	$44.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.18 / $188.14 / $238.35	Professional	TC	$126.18	$188.14	$238.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $143.97 / $189.31 / $317.63	Facility		$143.97	$189.31	$317.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $231.63 / $245.67 / $280.76	Professional		$231.63	$245.67	$280.76
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.64 / $38.50 / $44.00	Professional	26	$24.64	$38.50	$44.00
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $195.34 / $213.10 / $236.78	Professional	TC	$195.34	$213.10	$236.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.70 / $35.79 / $204.12	Professional		$31.70	$35.79	$204.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $222.91 / $222.91 / $222.91	Facility		$222.91	$222.91	$222.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $186.49 / $219.40 / $245.70	Professional		$186.49	$219.40	$245.70
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $29.18 / $34.33 / $37.79	Professional	26	$29.18	$34.33	$37.79
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $157.31 / $185.07 / $207.90	Professional	TC	$157.31	$185.07	$207.90
United Facility/Professional Professional Modifier Low / Median / High Price $166.82 / $241.68 / $356.16	Professional		$166.82	$241.68	$356.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.17 / $26.98 / $39.75	Professional	26	$15.17	$26.98	$39.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.56 / $216.70 / $335.45	Professional	TC	$122.56	$216.70	$335.45